The prevalence of online sharing of breast milk is impossible to quantify, but it has caught the attention of the Food and Drug Administration. Last fall, the FDA released a statement that recommended “against feeding your baby breast milk acquired directly from individuals or through the Internet” because unscreened donor milk could allow the transmission of HIV, chemical contaminants, some illegal drugs and some prescription drugs.
Some women’s intense desire to breast-feed exclusively may be a result of the “breast is best” message coming from the U.S. surgeon general, the American Academy of Pediatrics (AAP), the Department of Health and Human Services’ Breastfeeding Awareness Campaign and even first lady Michelle Obama. According to the AAP, breast-feeding decreases the likelihood of a variety of infectious diseases, ear infections and diarrhea, among other benefits.
With all this pro-lactation advocacy, “it’s a logical outcome that mothers would be extremely nervous if they have an insufficient supply or really don’t like breast-feeding,” says Joan B. Wolf, a social scientist and the author of “Is Breast Best?” In the book, Wolf argues that the benefits of breast-feeding have been overstated.
To mothers such as Terry, feeding formula to her baby feels less healthful and therefore more risky than using unscreened milk from a stranger.
Terry, who works full time at a nonprofit organization, had been exclusively breast-feeding her daughter Blossom for four months when her pediatrician concluded that the baby wasn’t gaining enough weight.
After being born last August at a healthy 7 pounds, 7 ounces, Blossom weighed only about 10 pounds at 4 months and had nearly dropped off the height and weight charts. She would “scream nonstop” during and after feedings, Terry says. A lactation consultant determined that Terry had an insufficient supply of milk: Blossom was getting only about an ounce and a half of milk each time she nursed. (Babies of that age drink about 30 ounces a day.) Neither the consultant nor the doctor knew why.
“I was in a very dark place the day I bought a can of formula,” Terry says. “I was admitting defeat, that my body had failed to feed my daughter.” Terry cried as she fed Blossom formula for the first time.
The lactation consultant had mentioned an online organization called Eats on Feets (a play on Meals on Wheels) that might be able to find Terry donor breast milk. Emma Kwasnica, a mother in Montreal, launched the group globally on Facebook in October. In just four months, Eats on Feets had grown to more than 120 chapters, including a chapter in Northern Virginia and one serving Washington and Maryland. (Kwasnica recently left Eats on Feets to start a new organization, Human Milk 4 Human Babies.)
No more formula
Despite her initial hesitation about feeding Blossom another woman’s milk, Terry felt adamant about not using any more formula. While pregnant, she had attended meetings of La Leche League, the international breast-feeding support and advocacy group, and read up on the health benefits of breast milk.
“Formula is not what her body was meant to eat,” Terry says. “As mammals, we have mammary glands, and it’s my belief, based on what I’ve learned, that breast milk is not just what’s best for the baby, it’s what’s normal. It’s what they’re supposed to be eating.”
Terry described her situation on the Eats on Feets discussion page on Facebook. Within a day, a stay-at-home mom in Fort Belvoir offered to pump extra milk for Blossom, and Terry jumped at the chance. (No money changes hands in transactions arranged through Eats on Feets.)
Now, every Saturday, Terry drives three hours round-trip to pick it up. The woman who pumps for her, Amanda Brewer, once received breast milk through Eats on Feets. Her son had a food allergy, and Brewer decided she needed milk from a mom who didn’t eat dairy while she cleansed her own body of dairy for two weeks.
Pat Shelly, a Washington lactation consultant who is called “the breast whisperer” by clients, said that while she doesn’t have numbers for how much milk-sharing is going on, she thinks there must be more than in the past because, counterintuitively, fewer clients are asking her about it.
“The thinking among young people now is ‘It must be all right. Everyone is doing it. It’s on Facebook.’ That’s what I’m seeing now,” she says. “They’re not looking for validation” from a health-care provider.
The FDA’s statement encouraged women to consider milk banks instead of turning to the Internet. Milk banks may charge as much as $6 an ounce; at that price, it could cost about $150 a day to feed the average 3-month-old baby.
The FDA does not regulate milk banks or milk-sharing, but it posted facts about these options after realizing that people were turning to the agency for information, said spokesman Jeff Ventura.
The Human Milk Banking Association of North America (HMBANA) operates nine nonprofit milk banks in the United States; the one closest to Washington is in Raleigh, N.C.
The banks are designed to serve babies in neonatal intensive care units, says the group’s president, Jean Drulis, though they provide milk to healthy babies “when possible.” HMBANA recently announced that all of its milk banks have a critical shortage, making it extremely unlikely that a baby such as Blossom would qualify to receive milk right now. Plus, the milk is available only with a doctor’s prescription, and only some health insurance plans cover the cost.
“The milk banks can only do so much,” Drulis says.
A century of change
Breast-feeding was almost universal at the turn of the 20th century, but the practice declined until in 1972 only 22 percent of U.S. mothers nursed their babies, according to a study in the Journal of Nutrition. By 2007, though, 75 percent of infants were breast-fed, according to the Centers for Disease Control and Prevention. Both of those statistics include all breast-feeding women, from those who tried it only a few times to those who breast-fed exclusively for months or longer.
What changed? Since 1990, nearly 15,000 studies about breast-feeding have been published, and the evidence suggests that the average breast-fed baby has fewer illnesses than the average formula-fed baby, says Wolf, the social scientist.
Online milk-sharing communities are based on the idea of informed choice, Kwasnica says. It’s up to the participants to do their own research on the risks, but the organizations offer tips on how to flash-pasteurize breast milk and screening questions a milk recipient should consider asking the donor.
Suzanne Terry was so thrilled when Amanda Brewer offered to pump milk for Blossom that she initially forgot to ask her any such questions. The next day, she e-mailed Brewer and asked about her diet, which medications she took, if she used drugs or alcohol and if she had any diseases, and was reassured by the answers.
“I trusted her because it would never occur to me that someone who wasn’t taking care of themselves would be posting on an organization like Eats on Feets that they have extra breast milk that they are willing to donate,” Terry says. “That comes from a kind-hearted, generous person.”